NPI | 1750576278 |
---|---|
Entity Type | Organization |
Authorized Contact | GERALD LELAND TORGESON Owner 801-262-1181 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: UT 6492935-9922) |
Enumeration Date | 2007-09-07 |
Last Update Date | 2012-01-13 |